Preoperative analysis of platelet aggregability in carotid surgery

To evaluate the relationship between preoperative analysis of platelet aggregability and perioperative complications, we analyzed 42 patients who underwent carotid endarterectomy or carotid artery stenting. The effect of antiplatelet drugs was tested by whole blood aggregometry. ADP (adenosine-diphosphoric acid) and collagen were used as agonists. According to platelet aggregability, patients were classified into 4 groups (class A: highly inhibited, class B: moderately inhibited, class C: normally inhibited, class D: non-inhibited). Seven (32%) of 22 patients were stratified as clopidogrel nonresponders, whereas four (10%) of 40 patients were aspirin nonresponders. Hemorrhagic complications were registered in four patients. All of them were classified as class A. Ischemic complications occurred in two patients, one was classified as class C, the other was class D. Preoperative analysis of platelet aggregability could be useful to reduce the risk of perioperative complications after carotid surgery.